We have all heard the phrase “sleep with one eye open”. But we bet most of you didn’t know that sleeping with one eye open is an actual medical condition known as nocturnal lagophthalmos.
Some people might not even realize that they are sleeping with their eyes open. They wake up every day with dry irritated eyes and do not know why they are feeling this way. Most people don’t know that they sleep with one eye open unless someone points it out.
What This Article Is All About?
Sleeping with one eye open may seem like a weird habit and not a big deal. But if left untreated, this minor eccentric habit may cause serious damage to your eye.
Your eyes are one of the most sensitive parts of the body. The eyelids are responsible for protecting your eye from all types of harmful stimuli. When you close your eyes during sleep the eyelids help protect your eye from dust, bacteria, accidental scratching, and many other things. When you close your eyes, your eyelids help spread a layer of moisture over your eyeball to keep it hydrated and clear away any harmful particles or bacteria.
Now imagine the type of damage your eyes may sustain if you sleep with your eyes open. The possibilities are numerous and daunting.
In this article, we will discuss the symptoms, causes, treatment options, and safety measures people with nocturnal lagophthalmos should take.
Role of Your Eyelids
Before we jump into the causes and treatments for sleeping with one eye open, let’s have a look at why sleeping with our eyes closed is so important.
Your eyelids provide a physical barrier against bacteria, dust, and other particles. When you close your eyelids, a layer of moisture (due to tear formation) is spread over your eyes. The tears not only provide lubrication and nutrients but also contain natural antibiotics.
If you sleep with one eye open, your eye can become inflamed due to dryness. This can lead to various eye problems.
Symptoms of Sleep With One Eye Open
Like mentioned before, most people don’t even know they sleep with one eye open until someone points it out. But there are still some symptoms that may give you indications for nocturnal lagophthalmos.
When you close your eyes, it helps to lubricate the eyeball. Without proper lubrication, your eyes will become irritated or infected. Below are a few symptoms that may indicate that you sleep with one eye open:
- Irritated eyes
- Dry eyes
- Red puffy eyes
- Burning sensation in your eyes.
- Blurred vision
- Light sensitivity
- Poor sleep quality
Causes of Nocturnal Lagophthalmos:
The facial movements that you do are due to various facial muscles that have different functions. Orbicularis oculi is the facial muscle that is responsible for closing your eyelids.
Any muscular or neural problem related to this muscle can lead you to sleep with your eyes open. This muscle is present bilaterally (one orbicularis oculi muscle on one side of the face). If both muscles are affected then you sleep with both eyes open but if only muscle on one side is affected then you sleep with one eye open and one eye closed.
The causes of nocturnal lagophthalmos are given below:
- Bell’s palsy: Bell’s palsy is a condition that affects the facial nerve. The facial nerve controls the orbicularis oculi muscle. Thus, if the facial nerve goes haywire, orbicularis oculi stop working properly. This leads to nocturnal lagophthalmos.
- Trauma or injury of the facial nerve or orbicularis oculi muscle
- Tumor compressing the facial nerve or orbicularis oculi muscle
- Neuromuscular diseases
- Graves’ ophthalmopathy: This is a disease that occurs due to an overactive thyroid gland. This causes bulging of the eyeball, making it hard to close your eyelid.
- Autoimmune diseases like Guillain-Barré syndrome
- Various infections can also cause you to sleep with one eye open. Some infections that may cause nocturnal lagophthalmos are:
- Lyme disease
- Physical damage to the eyes or surrounding structures can also cause you to sleep with one eye open.
Visit Your Doctor
If you suspect you have nocturnal lagophthalmos or someone has pointed it out to you then please do not be afraid to visit your doctor. Nocturnal lagophthalmos is not something to be ignored or taken lightly. You might not experience any major short-term effects but in the long run nocturnal lagophthalmos can be dangerous for your eyes.
When you visit your doctor, he or she will start by asking questions about your symptoms and what aggravates or relives them.
After taking a proper detailed history they will have a physical look at your eyes. They may also recommend some tests like a slit lamp exam and a fluorescein eye stain test.
Treatment Options For Sleeping With One Eye Open
We have discussed the problem but now let’s discuss its treatment options. For the proper treatment of nocturnal lagophthalmos, you must visit your doctor. The type of treatment you need depends on the cause of nocturnal lagophthalmos.
In this section, we will discuss the various ways nocturnal lagophthalmos can be managed.
The first step in managing nocturnal lagophthalmos is taking precautions. Below are some precautions your doctor may advise:
- Wearing a sleeping mask or goggles at night.
- Closing your eyelids using surgical tape.
- Using external eyelid weights to close your eyes. These weights are worn on the outside of your upper eyelids. This helps to forcefully shut your eyes.
- You can also try a humidifier in your room. This is advised to prevent drying of the eyes.
Medications are the second step for the management of nocturnal lagophthalmos. Below are a few medications that the doctor commonly advise to people suffering from nocturnal lagophthalmos:
- Eye drops: These are prescribed to keep the eyes lubricated.
- Artificial tears (they should be administered at least four times per day). These are advised to help lubricate the eye and rinse out any bacteria and debris.
- Ophthalmic ointments are advised to prevent scratches to the eyeball.
- Antibiotic eye drops are prescribed to treat any infection that may be causing nocturnal lagophthalmos.
Surgery is the final option for the treatment of nocturnal lagophthalmos. Most of the people who sleep with one eye open do not need surgery. Their condition is managed with precautions and medications. Surgery may not be the answer for everyone suffering from nocturnal lagophthalmos. Because the treatment plan devised depends on the cause of the problem.
In severe cases of paralysis, gold surgical eyelid implants maybe helpful for you. The function of this implant is to make the upper eyelid heavier, so your eyes close properly. The concept is like external eyelid weights but this is a more permanent solution.
Placing the eyelid implant is a short and relatively simple procedure. The doctor will make a small incision on the outside of your upper eyelid just above the lash line. A small gold implant is placed in the pocket created due to the incision. The implant is held in place with the help of stitches. The incision is closed and an antibiotic ointment is applied to the eyelid.
After the surgery, you may feel that your eyelid is a little thicker than before but the implant is usually not noticeable.
After the surgery you may experience:
- Bruising around the eyes.
These problems usually are minor and last for only a day or so.
Complications of Sleeping With Eyes Open:
Sleeping with one eye open may not seem like a big deal but in the long run, it can be severely detrimental to your health. Your eyes are one of the most sensitive parts of your body.
Minor irritation or damage to the eyes can lead to serious problems. Some of the complications that can occur due to sleeping with your eyes open for a long time are:
- Infection of the eyes
- Detrimental effect on eyesight
- Loss of vision.
- Increased risk of corneal ulcer.
- Increased risk of scratches to the eyes.
- Exposure keratopathy.
Sleeping with one eye open is not a serious condition. It can be mostly managed with simple solutions like eye drops or lid weights.
But the important thing is to look for the cause of nocturnal lagophthalmos. The simple symptom of sleeping with one eye open maybe an indication of a serious underlying condition.
“It’s better to be safe than sorry”. This is a famous saying and it applies to sleeping with one eye open. It’s better to take this condition seriously and seek treatment before any complications arise.
Even in severe cases, nocturnal lagophthalmos can be treated with lid implant surgery with a 90 percent success rate. But if the lid implants cause any problems, they can be easily removed.
Dr. Muhammad Usman is a Doctor, Nutritionist, Wellness Coach and a Researcher with a deep insight into all aspects of writing related to health and science.